1. Community Preparation for Caring for Mechanical Circulatory Device Patients
University of Wisconsin Hospital
And Clinics
Ventricular Assist Device Program

2. Mechanical Circulatory Support Device Overview
MCDSs are devices to support the failing heart (one side or both)
Most MCDS patients are anticoagulated with Coumadin and Aspirin
All MCDSs have:
Pump (implanted inside the patient’s chest)
Computer to control the settings/ display VAD performance readings
Power source: batteries or console connected to AC power

3. HeartMate II Components
Pump implanted inside the chest
One of two batteries needed to
power the pump
Driveline (tube connecting pump
to outside components) with sterile dressing covering it
Console used to obtain power
from AC outlet
Controller- computer runs device;
lights alarms
Republished with permission of Thoratec Corporation

4. HeartMate II VAD Readings
Flow= cardiac output from the pump
Target varies by patient
Speed= how fast pump is running rpm
range rpm
Power= how much watts it takes to run the pump
- normal is < 8 watts

5. HeartMate II Care Overview
Cannot palpate a pulse
Pulse oximeter may/ may not work
Need to assess if pump is running: listen over the point of maximal impulse (PMI) area for a consistent mechanical hum
Blood pressure: need a Doppler and sphygmomanometer
result is considered a MAP
acceptable MAP mmHg

6. HeartMate II Care Overview
EKG conduction-
does not impact VAD function unless RV fails
VAD will continue to receive blood supply until RV fails or pulmonary hypertension
Most of these patients have an ICD/ pacer. Some patients’ ICDs are off to avoid inappropriate shocks.
Most VAD patients tolerate the arrhythmias well and may have little symptoms for period of time.
Assess for patient’s tolerance of situation (if able). Ask for symptoms: lightheadedness, shortness of breath, palpitations, bloating, pain (anywhere), fever, chills, diaphoresis

7. HeartMate II Controller Face
Battery
Fuel Gauge
Battery Alarm light (yellow and red)
Silence
Alarm
Button
Test System
button
Power Symbol
(green light lit when pump running)
Controller
Cell Symbol
(yellow)
Red Heart Symbol lit: ? Pump running or not. Check PMI for mechanical hum.

8. HeartMate II Newer Controller Face Plate

9. EMERGENCY CARE
Call implant hospital: and ask for HEART FAILURE ATTENDING ON CALL
Still need to follow Airway Breathing of ABC’s
√ VAD stopped (listen over PMI area for consistent mechanical hum). If stopped significant risk for clot inside MCDS and thromboembolize.
No chest compressions
Defibrillation- STANDARD METHOD
Heparin bolus if VAD stopped (contact implant hospital first)

10. Contacts 608-263-6400 (Paging Operator) Heart Failure Attending
Ventricular Assist Device Coordinator (non-emergency)